{ "name": "Residency rules by state", "description": "Training-license requirements, who applies, fees, lead times, when a full license becomes available, and the state income-tax treatment a new resident faces.", "source": "https://www.joinandwise.com/residency", "license": "https://creativecommons.org/licenses/by/4.0/", "attribution": "Andwise (https://www.joinandwise.com)", "citation": "Andwise, \"Residency rules by state\" (2026-10-21). https://www.joinandwise.com/residency", "lastVerified": "2026-10-21", "scope": "United States, 50 states and DC", "note": "Board rules change without notice. Each row carries a confidence label and a check date; confirm against the board before applying.", "count": 51, "data": [ { "code": "AL", "name": "Alabama", "board": { "name": "Alabama Board of Medical Examiners", "url": "https://www.albme.gov/" }, "trainingLicense": { "required": "varies", "name": "Limited License (resident or fellow)", "whoApplies": "Resident applies personally; the dean, chief medical officer or program director certifies the training by letter.", "leadTime": null, "fee": "$175 certificate of qualification plus $75 license issuance; annual renewal $15 plus $300", "renewal": "Annual", "notes": "Alabama law does not require residents to hold a license. The board says individual programs require either a limited or a full license, so the need depends on the program. A resident who is serving an approved one-year residency can qualify, so PGY-1 residents are eligible. The limited license restricts practice to the residency or fellowship program, so moonlighting is not allowed, and it does not convert to a full license. IMGs also need ECFMG certification, unless their school is primarily English-speaking. Since July 1, 2025, the board treats Canadian graduates as IMGs.", "source": "https://www.albme.gov/licensing/md-do/license-types/limited-license/" }, "fullLicenseFrom": "After 1 year of ACGME, AOA or Canadian training for US graduates (MD or DO); 2 years for graduates of non-accredited schools, which since July 1, 2025 include Canadian schools.", "incomeTax": { "type": "progressive", "rate2026": "top rate 5% above $3,000", "localTaxNote": "Some cities, including Birmingham and Gadsden, withhold occupational taxes from the wages of people who work there.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "The Board of Medical Examiners issues a certificate of qualification and the Medical Licensure Commission then issues the license; both cover MDs and DOs." }, { "code": "AK", "name": "Alaska", "board": { "name": "Alaska State Medical Board", "url": "https://www.commerce.alaska.gov/web/CBPL/ProfessionalLicensing/StateMedicalBoard.aspx" }, "trainingLicense": { "required": "yes", "name": "Resident Permit", "whoApplies": "Resident, on a signed and notarized paper application; the program director sends a verification of good standing and the Alaska facility sends an acceptance of responsibility.", "leadTime": "Board form: average processing time is six to eight weeks; it asks applicants to plan accordingly.", "fee": "$100", "renewal": "Valid for the residency at the Alaska institution, up to 36 months; renewable for up to 36 more months with board approval of a new application", "notes": "State law requires a permit to serve as a resident or intern in Alaska, including residents from out-of-state programs rotating in Alaska. The permit is limited to the residency, so it does not cover moonlighting. Facts come from the board's permit form (revised 2024) and its statutes and regulations.", "source": "https://www.commerce.alaska.gov/web/portals/5/pub/med4022.pdf" }, "fullLicenseFrom": "After 2 years of postgraduate training for US graduates (MD or DO) who graduated on or after January 1, 1995; 3 years for IMGs, or an alternative the board accepts such as ABMS certification.", "incomeTax": { "type": "none", "rate2026": null, "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "AZ", "name": "Arizona", "board": { "name": "Arizona Medical Board", "url": "https://www.azmd.gov/" }, "trainingLicense": { "required": "yes", "name": "Postgraduate Training Permit", "whoApplies": "Resident and the sponsoring hospital complete the registration form together.", "leadTime": "Board form: register at least 30 days before training starts.", "fee": "$50 per year", "renewal": "Annual; residents register for each year of training", "notes": "Residents without a full Arizona license need this one-year renewable permit (A.R.S. 32-1432.02); the licensing exemptions do not cover residents. The permit limits practice to the supervised training program, so it does not cover moonlighting. The registration form is linked from the board's forms page.", "source": "https://www.azmd.gov/FormsIndex/FormsIndex" }, "fullLicenseFrom": "MD: after a 12-month approved internship, residency or fellowship for US/Canadian graduates; IMGs must also be enrolled in an additional approved 24-month program (A.R.S. 32-1423). DO: after an approved internship or the first year of a residency.", "incomeTax": { "type": "flat", "rate2026": "2.5%", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "DO residents get a postgraduate training permit from the separate Arizona Board of Osteopathic Examiners in Medicine and Surgery: $50 a year, submitted through the Arizona program director at least 30 days before the start date (per that board's 2019 instructions)." }, { "code": "AR", "name": "Arkansas", "board": { "name": "Arkansas State Medical Board", "url": "https://www.armedicalboard.org/" }, "trainingLicense": { "required": "no", "name": null, "whoApplies": null, "leadTime": null, "fee": null, "renewal": null, "notes": "Arkansas issues no resident training license. The Medical Practices Act exempts services by interns, residents and fellows in approved training programs (A.C.A. 17-95-203). The exemption covers work within the program; moonlighting needs a full license. The board's Graduate Registered Physician license is for graduates who did not match and ends when the holder enters residency.", "source": "https://www.armedicalboard.org/Professionals/pdf/mpa.pdf" }, "fullLicenseFrom": "After 1 year of US internship or residency for US graduates (MD or DO). IMGs: 3 years of accredited US training, or 1 year plus current enrollment in an accredited Arkansas program.", "incomeTax": { "type": "progressive", "rate2026": "top rate 3.7%; for net income up to $94,700 it applies above $26,400 (thresholds are adjusted annually for inflation)", "localTaxNote": null, "source": "https://www.arkleg.state.ar.us/Home/FTPDocument?path=%2FACTS%2F2026S1%2FPublic%2FACT2.pdf" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs. Act 2 of the 2026 First Extraordinary Session (approved May 6, 2026) cut the top rate from 3.9% to 3.7% for tax years beginning on or after January 1, 2026; the Tax Foundation's February 2026 table predates it." }, { "code": "CA", "name": "California", "board": { "name": "Medical Board of California", "url": "https://www.mbc.ca.gov/" }, "trainingLicense": { "required": "yes", "name": "Postgraduate Training License (PTL)", "whoApplies": "Resident, online through BreEZe; the program sends an enrollment form directly to the board.", "leadTime": "No set lead time; the board encourages applying once enrollment is confirmed. The PTL must be obtained within 180 days of starting training.", "fee": "$674 (includes the $49 fingerprint fee)", "renewal": "Not renewable; valid 36 months while enrolled in a California program", "notes": "Every resident in a California ACGME program must hold a PTL or a full license within 180 days of starting; after that, training without one is unlicensed practice. Residents who arrive with 12 (US/Canadian graduates) or 24 (IMGs) months of prior training credit must get a full license within 180 days instead. The PTL covers resident duties in the program and its affiliated sites, or other practice the program director approves in writing. Applicants need passing USMLE Step 1 and Step 2 CK scores.", "source": "https://www.mbc.ca.gov/Licensing/Postgraduate-Training-Licensees/Apply.aspx" }, "fullLicenseFrom": "MD: after 12 months of approved training credit for US/Canadian graduates and 24 months for IMGs; 36 months must be verified by the first license renewal. DO: after 12 months (PGY-1) plus COMLEX Level 3.", "incomeTax": { "type": "progressive", "rate2026": "top rate 13.3% above $1,000,000 (includes the 1% mental health services tax)", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "DO residents get their PTL from the separate Osteopathic Medical Board of California, with the same 180-day deadline and a $491 fee." }, { "code": "CO", "name": "Colorado", "board": { "name": "Colorado Medical Board", "url": "https://dpo.colorado.gov/Medical" }, "trainingLicense": { "required": "yes", "name": "Physician Training License", "whoApplies": "Resident, online; the program director or supervising physician signs a Training Program Statement.", "leadTime": "State law: the program's statement must reach the board at least 30 days before the resident starts, and the license lapses if a complete application is not received within 60 days after starting.", "fee": null, "renewal": "Valid 3 years (expiring August 31); renewable once for 3 more years", "notes": "Residents without a full Colorado license need a training license, except for Colorado rotations of 60 days or less. The license allows practice only under supervision and only for the named program, so moonlighting is not covered, and it ends when the resident leaves the program. The board does not publish the fee on the pages read; state law caps it at $50.", "source": "https://dpo.colorado.gov/Medical/Applications" }, "fullLicenseFrom": "After 1 year of board-approved postgraduate training, for US graduates (MD or DO) and IMGs (who also need ECFMG certification).", "incomeTax": { "type": "flat", "rate2026": "4.4%", "localTaxNote": "Some cities charge a flat monthly Occupational Privilege Tax on people who work there. Denver's employee share is $5.75 a month once Denver earnings reach $500 in the month; Aurora and Greenwood Village charge $2.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs. A TABOR surplus can trigger a temporary rate cut, but the September 2026 Legislative Council forecast says no TABOR refunds will be paid for tax year 2026." }, { "code": "CT", "name": "Connecticut", "board": { "name": "Connecticut Department of Public Health, Physician Licensure", "url": "https://portal.ct.gov/dph/practitioner-licensing--investigations/physician/physician-licensure" }, "trainingLicense": { "required": "yes", "name": "Residency training permit", "whoApplies": "Program. The residency program administrator sends DPH a list of enrolled residents and certifies their eligibility.", "leadTime": null, "fee": null, "renewal": "Covers the training period the program reports; revoked if the resident leaves the program", "notes": "No one may take part in a Connecticut residency until DPH issues this permit, which the program requests for the resident. The permit covers graduate medical education only, so moonlighting is not covered. IMGs need ECFMG certification, a Fifth Pathway, or another qualifying credential. DPH publishes no fee or processing time. Some programs also require a full license.", "source": "https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/Physician/Residency-Training-Permits" }, "fullLicenseFrom": "After 2 years of progressive ACGME or AOA training, for US/Canadian graduates (MD or DO) and IMGs.", "incomeTax": { "type": "progressive", "rate2026": "top rate 6.99% above $500,000", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "DPH licenses MDs and DOs, with the Connecticut Medical Examining Board." }, { "code": "DE", "name": "Delaware", "board": { "name": "Delaware Board of Medical Licensure and Discipline", "url": "https://dpr.delaware.gov/boards/medicalpractice/" }, "trainingLicense": { "required": "yes", "name": "Physician Training license (also called ACGME Training license; board rules call it an institutional certificate)", "whoApplies": "Resident, online through DELPROS, with an affidavit from the hospital's chief administrative officer; the institution usually pays the fee.", "leadTime": null, "fee": "$82 (the renewal fee is shown at renewal)", "renewal": "Annual; licenses expire March 31", "notes": "Delaware law requires a certificate to practice medicine and exempts medical students, not residents; the statute and board Rule 4.0 provide a hospital-limited certificate for interns, residents and fellows employed by Delaware hospitals. The board's 'When to Apply' text names only out-of-state residents rotating in Delaware for more than a month and house physicians, but the statute and rule cover all residents. Practice is limited to the employing hospital and duties the program assigns, so moonlighting is not covered. Renewal after the first year requires passing at least one licensing exam step.", "source": "https://dpr.delaware.gov/boards/medicalpractice/acgme/" }, "fullLicenseFrom": "After 1 year of ACGME training for US/Canadian graduates (MD or DO); 3 years of US training for IMGs.", "incomeTax": { "type": "progressive", "rate2026": "top rate 6.6% above $60,000", "localTaxNote": "Wilmington taxes its residents' earned income and nonresidents' pay for work in the city; state law caps the rate at 1.25%.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "One board licenses MDs and DOs." }, { "code": "DC", "name": "District of Columbia", "board": { "name": "District of Columbia Board of Medicine (DC Health)", "url": "https://dchealth.dc.gov/bomed" }, "trainingLicense": { "required": "yes", "name": "Medical Training License (MTL)", "whoApplies": "Resident, online with DC Health; the GME office acts as liaison and the program director submits attestations.", "leadTime": "Regulation: submit no later than 90 days before starting clinical training in DC. The board's page says to apply before the onsite start date.", "fee": "$150 (includes a $50 background check); renewal $105", "renewal": "First license up to 13 months, later licenses up to 3 years (rule effective September 11, 2026); renewals are filed March 1 to May 31", "notes": "DC Health requires every resident and fellow training in DC hospitals to hold an MTL unless they hold a full DC license. The MTL covers practice only in the program it was issued for. Residents from programs outside DC rotating in DC for up to 120 days use a separate Medical Training Registration. Applicants need USMLE Steps 1 and 2 (or COMLEX Levels 1 and 2) passed, and every application and renewal includes a background check. The board's web page lists a $50 renewal fee; its March 2026 FAQ and 2026 renewal notice say $105.", "source": "https://dchealth.dc.gov/service/board-medicine-medical-training-license-and-registrant-application" }, "fullLicenseFrom": "After 1 year of ACGME or AOA residency for US graduates (MD or DO); 3 years for IMGs (Canadian graduates from July 1, 2025 count as IMGs).", "incomeTax": { "type": "progressive", "rate2026": "top rate 10.75% above $1,000,000", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "FL", "name": "Florida", "board": { "name": "Florida Board of Medicine", "url": "https://flboardofmedicine.gov/" }, "trainingLicense": { "required": "yes", "name": "Registration of resident physicians, interns and fellows (physician-in-training registration)", "whoApplies": "Resident, individually; the board says the physician is responsible for obtaining a registration number before training starts. Each hospital reports its list of registered residents to the state.", "leadTime": "Submit the application and fee at least 60 days before the training start date.", "fee": "$200", "renewal": "Expires after 2 years unless renewed; residents pay no renewal fee", "notes": "Residents without an active Florida license must register and may not begin training until a registration number is issued. Registration limits practice to the approved training program. Residents may prescribe controlled substances under the hospital's DEA number with an individual suffix. Electronic fingerprinting is required.", "source": "https://flboardofmedicine.gov/resident-physicians-interns-fellows-and-house-physicians/" }, "fullLicenseFrom": "MD: after 1 year of approved residency for US graduates and graduates of foreign schools Florida has certified; 2 years in one specialty for other IMGs. DO: after 12 months of internship or residency.", "incomeTax": { "type": "none", "rate2026": null, "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "DO residents register with the separate Florida Board of Osteopathic Medicine: $100 initial fee, renewed every year for $100, the same 60-day lead time, and the board states that moonlighting is not allowed." }, { "code": "GA", "name": "Georgia", "board": { "name": "Georgia Composite Medical Board", "url": "https://medicalboard.georgia.gov/" }, "trainingLicense": { "required": "yes", "name": "Residency Training Permit (board rule: Temporary Postgraduate Training Permit)", "whoApplies": "Resident, online; the program director signs a Certificate of Postgraduate Training, and the GME office uploads a roster of residents.", "leadTime": null, "fee": "$150; renewal $75", "renewal": "Annual; permits expire June 30 and can be renewed for the length of the program, up to 7 years of training", "notes": "Board rule makes the permit mandatory for all postgraduate training in Georgia unless the trainee holds a Georgia license. Transferring programs requires a new application. The rule says the board issues permits within 45 days of a complete application. The board materials read do not address moonlighting. From July 1, 2025, ECFMG and ACGME treat Canadian graduates as IMGs for entering residency; the Georgia board has not adopted that for its permits or licenses.", "source": "https://medicalboard.georgia.gov/licensure-information/resident-training-physician" }, "fullLicenseFrom": "After 1 year of ACGME, AOA or Canadian training for graduates of board-approved schools (US, Canada, Puerto Rico and some foreign schools); 3 years for graduates of other schools.", "incomeTax": { "type": "flat", "rate2026": "4.99%", "localTaxNote": null, "source": "https://dor.georgia.gov/taxes/important-tax-updates" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs. HB 463 (signed May 2026) cut the rate from 5.19% to 4.99% retroactive to January 1, 2026; the Tax Foundation's February 2026 table shows the earlier 5.19%." }, { "code": "HI", "name": "Hawaii", "board": { "name": "Hawaii Medical Board", "url": "https://cca.hawaii.gov/pvl/boards/medical/" }, "trainingLicense": { "required": "yes", "name": "Limited and temporary license for residency training (MDR for MDs, DOSR for DOs)", "whoApplies": "Resident; the program director or a hospital representative signs an attestation with the application and each renewal.", "leadTime": null, "fee": "$57; renewal $45", "renewal": "Annual, for the length of training; the board sends no renewal notice", "notes": "Hawaii law bars practicing medicine without a license or a limited and temporary license, with no resident exemption. The residency license limits practice to the duties of the training position, so it does not cover moonlighting. The form says to renew at least one month before the one-year term ends.", "source": "https://cca.hawaii.gov/pvl/boards/medical/application_publication/" }, "fullLicenseFrom": "After 1 year of accredited residency for US/Canadian graduates (MD or DO); 2 years for IMGs.", "incomeTax": { "type": "progressive", "rate2026": "top rate 11% above $325,000", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "ID", "name": "Idaho", "board": { "name": "Idaho State Board of Medicine", "url": "https://dopl.idaho.gov/bom/" }, "trainingLicense": { "required": "yes", "name": "Temporary registration of interns and residents ('Medical Resident' registration)", "whoApplies": "Resident; an Idaho-licensed supervising physician approved by the board signs the application.", "leadTime": null, "fee": "$20", "renewal": "Annual", "notes": "Idaho law exempts interns and residents from licensure only while they are registered with the board, so every resident without a full Idaho license must register. Registration covers practice under the named supervising physician within the training program; registrants notify the board 14 days before changing supervisor or program.", "source": "https://dopl.idaho.gov/bom/" }, "fullLicenseFrom": "After 1 year of residency for US/Canadian graduates (MD or DO). IMGs: after 2 years at one accredited program, or 1 year in an Idaho program with program director approval and a contract to finish.", "incomeTax": { "type": "flat", "rate2026": "5.3%", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "IL", "name": "Illinois", "board": { "name": "Illinois Department of Financial and Professional Regulation (IDFPR)", "url": "https://idfpr.illinois.gov/profs/Physicians.html" }, "trainingLicense": { "required": "yes", "name": "Temporary Medical License (3-year)", "whoApplies": "Resident, to IDFPR, with proof of acceptance into a program; the license is kept in the hospital's custody.", "leadTime": "Department rule: file at least 60 days before training starts.", "fee": "$230", "renewal": "Valid up to 3 years; longer programs need an extension ($230 for 3 years, $165 for 2, $100 for 1); changing programs costs $20", "notes": "Illinois law has no resident exemption, and the Department's rule requires every resident without a full Illinois license to hold a temporary license before training starts. The license covers only practice within the residency program; moonlighting requires a full license. Residents from out-of-state programs rotating in Illinois use other routes, such as a visiting resident permit.", "source": "https://ilga.gov/ftp/JCAR/AdminCode/068/068012850A00900R.html" }, "fullLicenseFrom": "After 24 months of approved postgraduate clinical training, for US graduates and IMGs (MD or DO).", "incomeTax": { "type": "flat", "rate2026": "4.95%", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One licensing body covers MDs and DOs." }, { "code": "IN", "name": "Indiana", "board": { "name": "Medical Licensing Board of Indiana", "url": "https://www.in.gov/pla/professions/physicians-home/" }, "trainingLicense": { "required": "yes", "name": "Postgraduate Training Permit", "whoApplies": "Resident, online or on a paper form; the hospital or institution completes a certification form.", "leadTime": "Board recommends applying at least 60 to 90 days before the program starts; a permit can be issued before July 1 only if all documents arrive before then.", "fee": "$100; renewal $50", "renewal": "Annual; permits expire June 30", "notes": "A permit is required for each training program; one permit covers all sites in that program, and changing programs needs a new permit. Residents who hold a full Indiana license do not need one. The permit does not allow moonlighting, and holders cannot get an Indiana controlled substance registration. IMGs without an ECFMG certificate use a separate Non-ECFMG Training Permit.", "source": "https://www.in.gov/pla/professions/physicians-home/physicians-licensing-information/" }, "fullLicenseFrom": "After 12 months of accredited training for US/Canadian graduates (MD or DO); 24 months for IMGs.", "incomeTax": { "type": "flat", "rate2026": "2.95%", "localTaxNote": "All 92 counties levy a local income tax based on the county of residence on January 1: 0.5% to 3.0% (Marion County, which includes Indianapolis, 2.02%).", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "IA", "name": "Iowa", "board": { "name": "Iowa Board of Medicine", "url": "https://dial.iowa.gov/licenses/health-professions/physicians" }, "trainingLicense": { "required": "yes", "name": "Resident Physician License", "whoApplies": "Resident; the board does not accept third-party applications. The program director reports on each resident licensee every October 1.", "leadTime": null, "fee": "$100 plus a $45 fingerprint background check", "renewal": "None; the license expires on the program's expected completion date ($25 extension if training runs longer)", "notes": "Board rule requires a resident or full Iowa license for any resident in an Iowa training program. The license is valid only in the named program and only for supervised practice there; changing programs, including moving from residency to fellowship, needs a new license. Residents at federal facilities in Iowa do not need an Iowa license. The board says March to July is its busiest period and processing takes longer then.", "source": "https://www.legis.iowa.gov/docs/iac/chapter/09-30-2026.481.653.pdf" }, "fullLicenseFrom": "After 1 year of approved training for US graduates (MD or DO); 24 months for IMGs.", "incomeTax": { "type": "flat", "rate2026": "3.8%", "localTaxNote": "Many school districts add an income surtax of up to 20% of the resident's Iowa income tax, based on the district of residence on December 31. Six counties add an emergency medical services surtax.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "KS", "name": "Kansas", "board": { "name": "Kansas State Board of Healing Arts", "url": "https://www.ksbha.ks.gov/" }, "trainingLicense": { "required": "yes", "name": "Postgraduate Permit", "whoApplies": "Resident; the training program completes a certification form.", "leadTime": "The board's application packet asks applicants to allow at least 2 to 4 weeks for processing.", "fee": "$50, plus a $57 background check and a $3 data bank report fee", "renewal": "None; the permit ends on the program completion date or when a full license is issued", "notes": "Kansas law bars practice without a license or permit and does not exempt residents, so residents hold a postgraduate permit or a license. The permit covers practice only within the program and can be cancelled if the holder practices outside it. A separate Resident Active License allows moonlighting after 12 months of training and Step 3, with program approval and malpractice coverage ($100 application, $100 annual renewal).", "source": "https://www.ksbha.ks.gov/departments/licensing/licensure-types-designations/doctor-of-medicine-surgery" }, "fullLicenseFrom": "After 36 months of approved training for anyone who graduated on or after January 1, 2021 (MD or DO, US or IMG).", "incomeTax": { "type": "progressive", "rate2026": "top rate 5.58% above $23,000", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "KY", "name": "Kentucky", "board": { "name": "Kentucky Board of Medical Licensure", "url": "https://kbml.ky.gov/" }, "trainingLicense": { "required": "varies", "name": "From PGY-2: Residency Training License (R) or Institutional Practice Limited License (IP)", "whoApplies": "Resident, online; the Kentucky program director must submit an R Form recommendation.", "leadTime": "Board says the process takes about 6 to 8 weeks (30 to 60 more days with adverse history); training verification is not accepted before April 1.", "fee": "$75; renewal $65", "renewal": "Annual (academic year July 1 to June 30)", "notes": "First-year residents are exempt from licensure (KRS 311.560). After one year of training, residents need an IP license (Steps 1 and 2 passed) or an R license (all steps passed) and may not start PGY-2 until it is issued. The R license allows moonlighting at sites the program director designates and a DEA registration; the IP license limits practice to the program. The statute also says first-year trainees shall register with the board at no cost, but the board's pages describe no such registration.", "source": "https://kbml.ky.gov/physician/Pages/Types-of-Licenses.aspx" }, "fullLicenseFrom": "After 2 years of accredited training plus a licensing exam, for all graduates (MD or DO, US or IMG).", "incomeTax": { "type": "flat", "rate2026": "3.5%", "localTaxNote": "Many cities and counties levy occupational license taxes on wages, mainly where the work is done. Louisville Metro charges 2.2% for residents and 1.45% for nonresidents; Lexington-Fayette charges 2.25%, and Fayette County schools levy a separate tax.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "LA", "name": "Louisiana", "board": { "name": "Louisiana State Board of Medical Examiners", "url": "https://www.lsbme.la.gov/" }, "trainingLicense": { "required": "yes", "name": "PGY-1 Internship Registration, then a PGY-2 permit; IMGs: Graduate Education Temporary Permit (GETP)", "whoApplies": "Resident, online. The hospital administrator signs the PGY-1 registration, and the program director certifies PGY-2 and GETP applications.", "leadTime": null, "fee": "PGY-1 registration $50 (renewal $100); GETP $200. The PGY-2 permit fee is $100 on the board's page but $200 in its rule.", "renewal": "Issued for up to 12 months and renewable annually; the board issues no PGY-3 permit, so US graduates must pass all exam steps before the PGY-2 permit expires", "notes": "Board rule bars enrolling in a PGY-1 program without registering with the board. US graduates move to a PGY-2 permit after the first year; IMGs hold a GETP and must pass Step 3 within 24 months. The PGY-2 permit and GETP limit practice to the training program, so moonlighting requires a full license. The board says licensure processing in general takes from a few weeks to several months.", "source": "https://www.lsbme.la.gov/content/application-instructions-initial-licensure-internship-registration" }, "fullLicenseFrom": "US/Canadian graduates (MD or DO): after 2 years of accredited training, or 1 year plus a commitment for a second year, plus Step 3. IMGs: after 3 years in the same specialty.", "incomeTax": { "type": "flat", "rate2026": "3%", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "One board licenses MDs and DOs. The US-graduate training requirement could not be confirmed against the current text of LAC 46:XLV § 311; one medical school's guidance says 1 year of training plus Step 3. Confirm with the board." }, { "code": "ME", "name": "Maine", "board": { "name": "Maine Board of Licensure in Medicine", "url": "https://www.maine.gov/md/" }, "trainingLicense": { "required": "yes", "name": "Educational Certificate", "whoApplies": "Resident, through the FSMB Uniform Application and a Maine addendum; the Maine program documents enrollment and dates.", "leadTime": "Board FAQ lists 1 to 2 weeks of processing.", "fee": "$300 for 3 years (fee schedule dated 2018)", "renewal": "Renewable every 3 years, up to 7 years; ends when the resident leaves the program", "notes": "Maine law has no resident exemption. The educational certificate gives residents a licensed physician's rights, limited to their program at a specific hospital, so it does not cover moonlighting. On January 1, 2027 the MD and DO boards merge into a new Maine Board of Medicine (P.L. 2025, c. 738). The new law keeps one educational certificate for MD and DO residents, renewable every 3 years for up to 8 years with a $300 fee cap, but the new board's rules were still in draft in October 2026, so fees and terms for July 2027 may change.", "source": "https://www.maine.gov/md/licensure/license-types" }, "fullLicenseFrom": "MD: after 36 months of ACGME training (or ABMS certification); residents in a Maine program can be licensed after 24 months with the program director's endorsement if continuing to 36 months. DO graduates from 2026 onward: after 36 months.", "incomeTax": { "type": "progressive", "rate2026": "top rate 9.15% above $1,000,000 (7.15% bracket plus a 2% surcharge); 7.15% applies above $64,849", "localTaxNote": null, "source": "https://www.maine.gov/revenue/sites/maine.gov.revenue/files/inline-files/ta_august2026_vol36_iss10.pdf" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "Until the merger, DO residents register with the Maine Board of Osteopathic Licensure for a one-year temporary educational permit ($200), renewable up to 5 years. LD 2212 (April 2026) added a 2% surcharge on Maine taxable income above $1 million for single filers, starting with tax year 2026." }, { "code": "MD", "name": "Maryland", "board": { "name": "Maryland Board of Physicians", "url": "https://www.mbp.state.md.us/" }, "trainingLicense": { "required": "no", "name": null, "whoApplies": null, "leadTime": null, "fee": null, "renewal": null, "notes": "Maryland issues no resident training license. State law lets people in an accredited postgraduate training program practice without a license while doing their assigned program duties (Health Occupations 14-302). The exemption does not extend to practice outside the program.", "source": "https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gho§ion=14-302&enactments=false" }, "fullLicenseFrom": "After 1 year of accredited training for US/Canadian graduates (MD or DO); 2 years of accredited US training for IMGs.", "incomeTax": { "type": "progressive", "rate2026": "top rate 6.5% above $1,000,000", "localTaxNote": "Every county and Baltimore City levies a local income tax on residents, filed with the state return: 2.25% to 3.30% in 2026 (Baltimore City 3.20%).", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "MA", "name": "Massachusetts", "board": { "name": "Massachusetts Board of Registration in Medicine", "url": "https://www.mass.gov/orgs/board-of-registration-in-medicine" }, "trainingLicense": { "required": "yes", "name": "Limited License", "whoApplies": "Resident, online, after the training facility sends an invitation and invite code; the application cannot be started without it.", "leadTime": null, "fee": "$100 per year", "renewal": "Annual (issued for one academic year); renewed for the same program or on a change of program", "notes": "Massachusetts exempts trainees from full licensure only if they hold a limited license, so every resident holds a limited or full license. The limited license covers practice only in the named training program and its approved affiliates. Anyone who holds or has held a full Massachusetts license cannot get one. Use beyond seven total years needs a board vote. The board publishes no lead time and refers questions to program coordinators.", "source": "https://www.mass.gov/how-to/apply-for-my-physician-limited-license" }, "fullLicenseFrom": "After 2 years of ACGME, AOA or Canadian training for US/Canadian graduates (MD or DO); 3 years for IMGs. The board can consider shorter training for applicants licensed and board certified elsewhere.", "incomeTax": { "type": "progressive", "rate2026": "top rate 9% above $1,107,750 (5% rate plus 4% surtax)", "localTaxNote": null, "source": "https://www.mass.gov/info-details/tax-rates" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "MI", "name": "Michigan", "board": { "name": "Michigan Board of Medicine (LARA Bureau of Professional Licensing)", "url": "https://www.michigan.gov/lara/bureau-list/bpl/health/hp-lic-health-prof/medical" }, "trainingLicense": { "required": "yes", "name": "Educational Limited License, plus a controlled substance license", "whoApplies": "Resident, online through MiPLUS; the training hospital's Director of Medical Education sends a Certification of Appointment directly to the board.", "leadTime": "No apply-by date; the board says processing typically takes 4 to 6 weeks from receipt. US/Canadian graduates may apply up to 3 months before graduation.", "fee": "$93.60 for the educational limited license plus $93.70 for the controlled substance license; renewal $33.00 per year (controlled substance renewal $82.70)", "renewal": "Annual; renewable for no more than 5 years in total", "notes": "Board rule requires anyone not eligible for a full license to obtain the educational limited license before starting postgraduate training. The license confines practice to the approved hospital or institution, so it does not cover moonlighting. Changing programs requires a new Certification of Appointment. Applicants complete a fingerprint background check and state-required training on human trafficking, implicit bias and opioids.", "source": "https://www.michigan.gov/lara/bureau-list/bpl/health/hp-lic-health-prof/medical/medical-doctor-licensing-guides-and-faqs/md-educational-limited-licensing-guide-and-faqs" }, "fullLicenseFrom": "After 1 year of postgraduate clinical training, for US/Canadian graduates, IMGs and DOs (rules effective 2024 for MDs and 2023 for DOs).", "incomeTax": { "type": "flat", "rate2026": "4.25%", "localTaxNote": "Twenty-four cities levy income taxes. Detroit's 2026 rate is 2.4% for residents and 1.2% for nonresidents working in the city.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "DO residents apply to the separate Michigan Board of Osteopathic Medicine and Surgery for an Osteopathic Physician Educational Limited License with the same fees, renewal cycle and processing time." }, { "code": "MN", "name": "Minnesota", "board": { "name": "Minnesota Board of Medical Practice", "url": "https://mn.gov/boards/medical-practice/" }, "trainingLicense": { "required": "yes", "name": "Residency Permit", "whoApplies": "Resident, online or on paper; the Minnesota residency program completes the Approved Residency Training Program Form for the resident to submit.", "leadTime": null, "fee": "$20; extending the end date in the same program costs $15", "renewal": "No annual renewal; each permit covers one program's certified dates and ends when a full license is issued", "notes": "Minnesota law requires a residency permit to take part in a residency program unless the person holds a full license. A separate permit is needed for each program. The permit covers practice only within the residency program; moonlighting requires a full license. Holders notify the board within 30 days of leaving a program.", "source": "https://www.revisor.mn.gov/statutes/cite/147.0391" }, "fullLicenseFrom": "After 1 year of accredited graduate clinical training, for US/Canadian graduates and IMGs (MD or DO).", "incomeTax": { "type": "progressive", "rate2026": "top rate 9.85% above $203,150", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "MS", "name": "Mississippi", "board": { "name": "Mississippi State Board of Medical Licensure", "url": "https://www.msbml.ms.gov/" }, "trainingLicense": { "required": "yes", "name": "Restricted Temporary License", "whoApplies": "Resident, online through the board's MELS system, with a notarized affidavit and fingerprint cards by mail; schools and training institutions send verifications directly.", "leadTime": "Applications open three months before the program start date; the board publishes no processing time.", "fee": "$50; renewal $50", "renewal": "Annual, for the length of training, up to five years", "notes": "Board rules require a license before practicing in Mississippi, and residents who have not finished postgraduate training or Step 3 hold this license. It allows practice only within an approved training program in Mississippi, so it does not cover moonlighting. Residents from other states rotating in Mississippi for 4 weeks or less get a separate temporary training license. A $50 fee applies if staff find an application incomplete.", "source": "https://www.msbml.ms.gov/licensure/md-do-temporary-application" }, "fullLicenseFrom": "After 1 year of ACGME or AOA training for US/Canadian graduates (MD or DO); IMGs after 3 years, or 1 year plus ABMS board certification and board approval.", "incomeTax": { "type": "flat", "rate2026": "4% on taxable income above $10,000", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "MO", "name": "Missouri", "board": { "name": "Missouri State Board of Registration for the Healing Arts", "url": "https://pr.mo.gov/healingarts.asp" }, "trainingLicense": { "required": "yes", "name": "Temporary License (for interns, residents and fellows)", "whoApplies": "Resident completes the application; the superintendent of the training hospital sends it to the board.", "leadTime": null, "fee": "$25; renewal $25", "renewal": "Annual; the license ends when the holder leaves the training program", "notes": "Board rule bars applicants from practicing until the temporary license is issued. The license is tied to the training program, and prescribing, including controlled substances, is limited to the program's patients under the institution's DEA number. Residents of programs in neighboring states who rotate into Missouri use a provisional temporary license. The board's website has no page or form for this license, so these details come from its rules (20 CSR 2150-2.060 and 2.080).", "source": "https://www.law.cornell.edu/regulations/missouri/20-CSR-2150-2-060" }, "fullLicenseFrom": "After 1 year of ACGME or AOA training for US/Canadian MD and DO graduates. IMGs: 2 years under the statute as amended effective August 28, 2026 (HB 2372); the board rule still says 3 years.", "incomeTax": { "type": "progressive", "rate2026": "top rate 4.7% above $9,436", "localTaxNote": "Kansas City and St. Louis each levy a 1% earnings tax on residents and on nonresidents who work in the city; voters renewed both in April 2026.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "One board licenses MDs and DOs." }, { "code": "MT", "name": "Montana", "board": { "name": "Montana Board of Medical Examiners", "url": "https://boards.bsd.dli.mt.gov/medical-examiners/" }, "trainingLicense": { "required": "yes", "name": "Resident License", "whoApplies": "Resident, online; the residency program sends a letter of good standing directly to the board, and the applicant names a Montana-licensed supervising physician.", "leadTime": null, "fee": "$75", "renewal": "Issued for up to 1 year; renewable at the board's discretion for further 1-year periods", "notes": "Montana law bars practicing medicine before a license is issued and creates a resident license; residents are not among the statutory exemptions. The license covers residents in Montana programs and residents of out-of-state programs on approved Montana rotations, seeing patients under a Montana-licensed physician's supervision. The board's materials do not describe moonlighting on a resident license. The renewal fee was not found on the pages read.", "source": "https://boards.bsd.dli.mt.gov/_docs/med/res-phy-app.pdf" }, "fullLicenseFrom": "After completing PGY-1, if the resident stays enrolled and in good standing (2025 statute), or after completing residency.", "incomeTax": { "type": "progressive", "rate2026": "top rate 5.65% above $47,500", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "NE", "name": "Nebraska", "board": { "name": "Nebraska Board of Medicine and Surgery (DHHS Licensure Unit)", "url": "https://dhhs.ne.gov/licensure/Pages/Medicine-and-Surgery.aspx" }, "trainingLicense": { "required": "yes", "name": "Temporary Educational Permit (TEP)", "whoApplies": "Resident, on a paper application; an authorized program official (such as the associate dean for GME) signs the institution section.", "leadTime": null, "fee": "$25 (waived for applicants under 26, low-income applicants and military families); the $75 State Patrol background check is separate", "renewal": "Annual; all permits expire July 1", "notes": "Nebraska requires a license to practice medicine unless an exemption applies, and residents are not exempt, so each resident holds a TEP or a full license. The permit covers MD and DO residents and does not allow practice outside the assigned program. Applicants have 90 days after issue to complete the fingerprint background check, which the board says can take 8 to 10 weeks.", "source": "https://dhhs.ne.gov/licensure/Documents/TEPapp.pdf" }, "fullLicenseFrom": "MD: after 1 year of approved GME for US/Canadian graduates; 2 years for IMGs. DO: after 1 year of internship or equivalent.", "incomeTax": { "type": "progressive", "rate2026": "top rate 4.55% above $24,760", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "NV", "name": "Nevada", "board": { "name": "Nevada State Board of Medical Examiners", "url": "https://medboard.nv.gov/" }, "trainingLicense": { "required": "yes", "name": "Limited license to practice medicine as a resident physician", "whoApplies": "Resident; the sponsoring institution sends written confirmation of the appointment, and the program director certifies renewals.", "leadTime": null, "fee": "$425 ($300 application, $50 registration, $75 background check); renewal $50", "renewal": "Issued for up to 1 year and renewable; each renewal needs an annual report signed by the program director", "notes": "Nevada law has no licensure exemption for residents, so every MD resident without a full Nevada license holds this limited license. It covers practice in connection with residency duties or under conditions the program director approves. For non-citizens it lasts only as long as their work authorization. Residents from other states rotating in Nevada use a separate rotating resident license.", "source": "https://medboard.nv.gov/uploadedFiles/medboardnvgov/content/Forms/Licensure%20Fees(4).pdf" }, "fullLicenseFrom": "MD: after 36 months of progressive postgraduate training, or while in a program with less than 12 months remaining and a written commitment to finish (2025 statute); IMGs also need ECFMG certification. DO: after 3 years, or after 24 months in a Nevada program with a written commitment to finish.", "incomeTax": { "type": "none", "rate2026": null, "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "DO residents get a special resident license from the separate Nevada State Board of Osteopathic Medicine: $200 for the license and each renewal, valid up to 1 year, with renewals due 90 days before expiration. The program's residency coordinator must sponsor the resident in that board's portal first." }, { "code": "NH", "name": "New Hampshire", "board": { "name": "New Hampshire Board of Medicine (Office of Professional Licensure and Certification)", "url": "https://www.oplc.nh.gov/board-medicine" }, "trainingLicense": { "required": "yes", "name": "Resident Training License", "whoApplies": "Resident; the GME director and the program director sign to certify enrollment.", "leadTime": null, "fee": "$55; renewal $55", "renewal": "Board rule says the license expires 4 years after issue; the state fee rule lists a 2-year term. It ends if the resident leaves the program.", "notes": "State law has no resident exemption and directs the licensing office to issue training licenses to residents and fellows. The license covers practice only within the training program and its affiliated facilities, under supervision, so it does not cover moonlighting. Applicants need USMLE Step 1 and Step 2 results; IMGs also need ECFMG certification.", "source": "https://www.gc.nh.gov/rules/state_agencies/med100-600.html" }, "fullLicenseFrom": "After 2 years of ACGME or AOA training (PGY-1 and PGY-2), for all graduates; IMGs also need ECFMG certification.", "incomeTax": { "type": "none", "rate2026": null, "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "One board licenses MDs and DOs. New Hampshire's interest and dividends tax was repealed starting with tax year 2025; it never taxed wages." }, { "code": "NJ", "name": "New Jersey", "board": { "name": "New Jersey State Board of Medical Examiners", "url": "https://www.njconsumeraffairs.gov/bme/Pages/default.aspx" }, "trainingLicense": { "required": "yes", "name": "PGY-1: registration; PGY-2 and later: resident permit", "whoApplies": "Resident and program. The board lists online applications for PGY-1 registration and the resident permit; its rule has the program director certify and submit residents' materials.", "leadTime": "Board rule: the program director submits the PGY-1 list no later than one month before residents start, and permit applications no later than four months before PGY-2 begins.", "fee": "Permit: $50. The rule sets no fee for PGY-1 registration.", "renewal": "The permit is valid for the length of the training program; changing programs requires a transfer application", "notes": "Board rule bars unlicensed residents from practicing in PGY-1 until registered and in PGY-2 or later until they hold a permit. PGY-1 registrants are confined to the affiliated hospital and outpatient sites, with inpatient orders countersigned. Permit holders may moonlight for pay only with the program director's written approval and supervision by a fully licensed physician. The board's fee schedule is published as an image and could not be read, so the fee comes from the rule text (N.J.A.C. 13:35-1.5).", "source": "https://www.law.cornell.edu/regulations/new-jersey/N-J-A-C-13-35-1-5" }, "fullLicenseFrom": "After 2 years of ACGME or AOA training completed with credit plus a signed contract for a third year, for US graduates and IMGs who graduated on or after July 1, 2003. At least 2 of the 3 years must be in the same field, or in fields that count toward one ABMS or AOA specialty.", "incomeTax": { "type": "progressive", "rate2026": "top rate 10.75% above $1,000,000", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "One board licenses MDs and DOs." }, { "code": "NM", "name": "New Mexico", "board": { "name": "New Mexico Medical Board", "url": "https://www.nmmb.state.nm.us/" }, "trainingLicense": { "required": "yes", "name": "Postgraduate Training License", "whoApplies": "Resident, online; residents at the University of New Mexico apply through its GME office, which reviews applications before sending them to the board.", "leadTime": null, "fee": "$10, plus criminal history screening fees", "renewal": "Valid up to 1 year; renewable for up to 8 years or until residency ends", "notes": "Board rule requires the license for all interns, residents and fellows in board-approved New Mexico programs. Moonlighting requires a separate Public Service License ($50 a year), available after one year of training with the program director's written approval. Applicants need USMLE Step 1 or COMLEX Level 1.", "source": "https://www.nmmb.state.nm.us/licensing/" }, "fullLicenseFrom": "After 2 years of postgraduate training, or board approval of equivalent experience (MD or DO).", "incomeTax": { "type": "progressive", "rate2026": "top rate 5.9% above $210,000", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "The osteopathic board merged into the New Mexico Medical Board in July 2021, so DO residents apply to the Medical Board." }, { "code": "NY", "name": "New York", "board": { "name": "New York State Education Department, Office of the Professions", "url": "https://www.op.nysed.gov/professions/physicians" }, "trainingLicense": { "required": "no", "name": null, "whoApplies": null, "leadTime": null, "fee": null, "renewal": null, "notes": "NYSED does not require a license or limited permit for people employed in ACGME-approved training programs to work in those programs. It issues a limited permit ($105) for other supervised hospital practice, which ACGME residents do not need. NYSED's page does not address moonlighting.", "source": "https://www.op.nysed.gov/professions/physicians/license-requirements" }, "fullLicenseFrom": "After 1 year of accredited residency for graduates of accredited or NYS-registered schools (MD or DO); 3 years for graduates of other schools.", "incomeTax": { "type": "progressive", "rate2026": "top rate 10.9% above $25,000,000", "localTaxNote": "New York City residents pay city income tax of 3.078% to 3.876% (2026). Yonkers residents pay a surcharge of 16.75% of their net state tax; nonresidents pay 0.5% on wages earned in Yonkers.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "NYSED licenses MDs and DOs." }, { "code": "NC", "name": "North Carolina", "board": { "name": "North Carolina Medical Board", "url": "https://www.ncmedboard.org/" }, "trainingLicense": { "required": "yes", "name": "Resident's Training License (RTL)", "whoApplies": "Resident, online; the GME office collects documents and finalizes the application.", "leadTime": "No deadline published; the board says GME offices' document collection can take up to a month.", "fee": "$125 plus $38 for fingerprints; renewal $150 (raised by S.L. 2026-41, effective October 1, 2026; the board's own fee page still showed $100 and $125 in October 2026)", "renewal": "Annual, before the resident's birthday", "notes": "State law requires a license to practice medicine and has no resident exemption; the RTL is the limited license for GME. Practice is confined to the training program under the program director's supervision, so the RTL does not cover outside practice. It becomes inactive when the holder leaves the program. The board's renewal page still lists a $125 renewal fee.", "source": "https://www.ncmedboard.org/licensing-registration/licensing/residents" }, "fullLicenseFrom": "After 1 year of approved GME for graduates of LCME, CACMS or AOA schools; 2 years for IMGs (plus ECFMG certification). Current specialty board certification is an alternative.", "incomeTax": { "type": "flat", "rate2026": "3.99%", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "ND", "name": "North Dakota", "board": { "name": "North Dakota Board of Medicine", "url": "https://www.ndbom.org/" }, "trainingLicense": { "required": "yes", "name": "Postgraduate training license (resident license)", "whoApplies": "Resident, online; the medical school sends its certificate directly to the board.", "leadTime": null, "fee": "$105 (board website; the board rule says $100), plus a $43 background check", "renewal": "Valid for the whole program; annual certification of enrollment, no fee", "notes": "A resident may not start training until the license is granted. Completed files go to the next regular board meeting, and the board may issue a temporary license to bridge the gap. Residents of out-of-state programs may rotate in North Dakota for 90 days or less without a North Dakota license if licensed in their home program's state. The license does not permit moonlighting.", "source": "https://www.ndbom.org/practitioners/residents/apply/index.asp" }, "fullLicenseFrom": "After 1 year of approved training for US/Canadian graduates (MD or DO); 24 months for IMGs (since August 1, 2023).", "incomeTax": { "type": "progressive", "rate2026": "top rate 2.5% (above $244,825 in 2025; threshold indexed annually); income below $48,475 is taxed at 0%", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "OH", "name": "Ohio", "board": { "name": "State Medical Board of Ohio", "url": "https://med.ohio.gov/" }, "trainingLicense": { "required": "yes", "name": "Training Certificate", "whoApplies": "Resident, online through eLicense; the program director completes a Training Program Certification form, which the program sends to the board.", "leadTime": null, "fee": "$130 plus a $3.50 transaction fee; renewal $100", "renewal": "Valid 3 years; renewable once for 3 more years", "notes": "Board rule makes the certificate mandatory for residents and fellows without a full Ohio license, including residents from other states on elective rotations in Ohio. If the certificate is not issued by the start date, the board issues an acknowledgment letter that allows training for 120 days. The board asks applicants to allow 10 business days for initial review. Activities are limited to the training program, so moonlighting is not covered. Rotations through several hospitals need only one certificate per training year.", "source": "https://med.ohio.gov/apply-and-renew/licenses-and-certifications/training-certificate" }, "fullLicenseFrom": "After 12 months of GME (through the first-year level) for graduates of LCME or AOA schools; 24 months for ECFMG-certified IMGs.", "incomeTax": { "type": "flat", "rate2026": "2.75% on income above $26,050", "localTaxNote": "About 670 municipalities tax wages, mainly where the work is done (Columbus and Cleveland 2.5%, Cincinnati 1.8%). About 210 school districts add an income tax on their residents.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "OK", "name": "Oklahoma", "board": { "name": "Oklahoma State Board of Medical Licensure and Supervision", "url": "https://www.okmedicalboard.org/" }, "trainingLicense": { "required": "yes", "name": "Special training license", "whoApplies": "Resident, through the board's online portal; the appointing hospital or medical school must confirm each resident holds an Oklahoma license when training begins.", "leadTime": null, "fee": "$250; annual reregistration $150 (board rule effective September 1, 2026, which describes these as maximum amounts)", "renewal": "Annual reregistration", "notes": "Board rules require MD interns to hold a special training license, and hospitals that let a resident train without one risk losing board approval. Residents who have finished 12 months of training (24 months for IMGs) are expected to move to a full license; keeping a special training license after PGY-1 is an exception for special circumstances, though IMGs may renew it until they meet the full-license requirement. Applicants need USMLE Step 1 and Step 2 CK passed. The board's FAQ gives 6 to 8 weeks of processing for license applications in general. The rules read do not address moonlighting.", "source": "https://www.okmedicalboard.org/download/2501/EFFECTIVE+RULES-MD+Rules_Eff._09.01.2026.pdf" }, "fullLicenseFrom": "MD: after 12 months of progressive training in the same specialty; 24 months for IMGs. DO: after 1 completed year of postgraduate training.", "incomeTax": { "type": "progressive", "rate2026": "top rate 4.5% above $7,200", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "DO residents are licensed by the separate State Board of Osteopathic Examiners: a Resident Training license ($120) is required to begin PGY-1, and an advanced resident license, obtained through the standard license application, is required before PGY-2. Moonlighting on the advanced license needs a signed letter from the program's medical director naming each location." }, { "code": "OR", "name": "Oregon", "board": { "name": "Oregon Medical Board", "url": "https://www.oregon.gov/omb/Pages/default.aspx" }, "trainingLicense": { "required": "yes", "name": "Limited License, Postgraduate (LLPG)", "whoApplies": "Resident, online; the Oregon school of medicine or teaching hospital sends the board its list of incoming residents (or a letter for off-cycle starts).", "leadTime": null, "fee": "$185 per year, paid in full for the license term at application", "renewal": "Granted for up to 5 years, not beyond the training program; residents may choose a one-year license each year", "notes": "Oregon's licensing law has no exemption for residents, so residents hold the LLPG or a full license; a GME office that allows a resident to apply for a full license instead must send a signed letter. The LLPG limits practice to the accredited training program and does not allow moonlighting. Holders notify the board within 30 days of leaving the program.", "source": "https://www.oregon.gov/omb/licensing/Pages/Limited-Licenses.aspx" }, "fullLicenseFrom": "After 1 year of training in one program for US/Canadian graduates (MD or DO) and graduates of board-approved schools in England, Scotland, Ireland, New Zealand and Australia; 3 years for other IMGs.", "incomeTax": { "type": "progressive", "rate2026": "top rate 9.9% above $125,000", "localTaxNote": "Portland-area taxes apply to higher earners: Metro's 1% tax above $128,000 and Multnomah County's Preschool for All tax of 1.5% above $125,000 (single filers, 2026). Portland residents also owe a $50 arts tax.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "PA", "name": "Pennsylvania", "board": { "name": "Pennsylvania State Board of Medicine", "url": "https://www.pa.gov/agencies/dos/department-and-offices/bpoa/boards-commissions/medicine" }, "trainingLicense": { "required": "yes", "name": "Graduate License (Graduate Medical Trainee)", "whoApplies": "Program. The training hospital starts the application in the state's PALS system and pays the fee; the resident then completes and submits their part.", "leadTime": null, "fee": "$30 for graduates of accredited schools, $85 for graduates of unaccredited schools; renewal $15", "renewal": "Annual; valid up to 12 months and renewed each training year", "notes": "State rule bars practicing as part of a GME program without a graduate license, including short-term trainees and out-of-state rotators. Training at PGY-2 requires passing USMLE Steps 1 and 2 (or equivalent), and PGY-3 and above requires Step 3, unless the trainee holds a full license. The license covers training within the assigned hospital complex and program sites. Applicants complete an FBI fingerprint check and 3 hours of child abuse education. The board asks for early applications but publishes no lead time.", "source": "https://www.pa.gov/agencies/dos/department-and-offices/bpoa/boards-commissions/medicine/graduate-medical-training-application-and-submission" }, "fullLicenseFrom": "MD: after 2 years of training for graduates of accredited (US/Canadian) schools; 3 years for graduates of unaccredited schools (49 Pa. Code § 17.1, last amended April 2026). DO: after 1 year.", "incomeTax": { "type": "flat", "rate2026": "3.07%", "localTaxNote": "Most municipalities and school districts levy a local earned income tax, totaling 1% for most residents. Philadelphia's wage tax is 3.735% for residents and 3.425% for nonresidents from July 1, 2026; Pittsburgh residents pay 3%. Most workplaces also withhold a Local Services Tax, generally capped at $52 a year.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "DO residents get a temporary graduate training license from the separate State Board of Osteopathic Medicine: $140, $25 annual renewal, also started by the training hospital." }, { "code": "RI", "name": "Rhode Island", "board": { "name": "Rhode Island Board of Medical Licensure and Discipline (Department of Health)", "url": "https://health.ri.gov/licensing/physicians" }, "trainingLicense": { "required": "yes", "name": "Limited medical registration (training license)", "whoApplies": "Program. The application goes through the hospital or institution and is signed by its chief executive and the program director.", "leadTime": null, "fee": "$65; renewal $65 (the fee rule's 'Hospital Medical Officer (Limited)' line, the statutory category that covers residents)", "renewal": "Annual; renewable for up to four consecutive years", "notes": "Board rule bars anyone without a full license from working as an intern, resident or fellow in Rhode Island without a limited registration. It covers practice at the named hospital and approved affiliated sites under supervision. A resident who practices outside the program needs a full license. IMGs need ECFMG certification. The fee rule has no line labeled for residents, so the fee rests on reading the hospital medical officer line as the resident fee.", "source": "https://rules.sos.ri.gov/Regulations/part/216-40-05-1" }, "fullLicenseFrom": "After 2 years of progressive accredited training, for MDs, DOs and IMGs (IMGs also need ECFMG certification).", "incomeTax": { "type": "progressive", "rate2026": "top rate 5.99% above $186,450", "localTaxNote": "From 2027, the FY2027 budget (H 7127) adds a surtax on income above $1 million: 1% in 2027, 2% in 2028 and 3% from 2029.", "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "One board licenses MDs and DOs." }, { "code": "SC", "name": "South Carolina", "board": { "name": "South Carolina Board of Medical Examiners", "url": "https://llr.sc.gov/med/" }, "trainingLicense": { "required": "yes", "name": "Limited License (residency or fellowship training)", "whoApplies": "Resident, online; the program sends the contract or a recommendation letter, and the department chair or residency director completes a supervising physician form.", "leadTime": null, "fee": "$130 for one year or $75 for six months; renewal at the same rates", "renewal": "Annual; licenses run for the state fiscal year (July 1 to June 30) and must be renewed", "notes": "The board requires every physician in a South Carolina residency to hold a valid license before beginning to practice. The limited license is issued for one program, is not transferable, and moonlighting on it is forbidden. Practicing before approval brings a $25 late fee and a violation. Applicants complete a fingerprint background check. An older board rule lists a $150 fee; the 2025 fee regulation and the board's renewal form state $130.", "source": "https://llr.sc.gov/med/PDF/ApplicationsForms/Limited-License-MD-DO_Electronic_Package.pdf" }, "fullLicenseFrom": "After 1 year of approved residency for US/Canadian graduates (MD or DO). IMGs: 3 years, or 2.5 years in the current program with program certification, or 1 year plus ABMS/AOA certification or five years of licensure elsewhere.", "incomeTax": { "type": "progressive", "rate2026": "top rate 5.21% on income of $30,000 and above (1.99% below $30,000)", "localTaxNote": null, "source": "https://www.dor.sc.gov/news/information-about-h-4216" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs. H. 4216 (signed March 30, 2026) replaced the 0%/3%/6% brackets with two rates starting with tax year 2026; the Tax Foundation's February 2026 table shows the earlier 6% top rate." }, { "code": "SD", "name": "South Dakota", "board": { "name": "South Dakota Board of Medical and Osteopathic Examiners", "url": "https://www.sdbmoe.gov/" }, "trainingLicense": { "required": "yes", "name": "Resident license", "whoApplies": "Resident, on board forms.", "leadTime": null, "fee": "$50 (board rule; state law caps it at $50)", "renewal": "Valid up to 1 year; renewed on a board form", "notes": "South Dakota's medical practice law has no resident exemption, and practicing without a board license, certificate or permit is a misdemeanor, so residents hold a resident license or a full license. The license is forfeited if the holder leaves good standing in an accredited residency. Holders may not provide medical services outside the residency until they have completed one year of training. The board's website returned errors throughout this research, so these details come from state statutes and board rules.", "source": "https://sdlegislature.gov/api/Statutes/36-4-20.7.html" }, "fullLicenseFrom": "After 2 years of graduate medical education (board rule ARSD 20:47:03:03).", "incomeTax": { "type": "none", "rate2026": null, "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "One board licenses MDs and DOs." }, { "code": "TN", "name": "Tennessee", "board": { "name": "Tennessee Board of Medical Examiners", "url": "https://www.tn.gov/health/licensure/me.html" }, "trainingLicense": { "required": "varies", "name": "Special Training License, or a board-approved licensure exemption filed by the program", "whoApplies": "Program. For the license, the resident completes the personal sections and the sponsoring institution submits the application; for the exemption, the program director or dean files one application listing each resident.", "leadTime": null, "fee": "Special Training License: $30 ($25 license fee plus $5 state regulatory fee). Exemption: $10 per resident per year, paid by the program.", "renewal": "Annual (the license is renewed each year at the program director's request; the exemption fee is paid each year)", "notes": "Every resident without a full Tennessee license is covered by one of two routes, and the program decides which: a Special Training License or a licensure exemption that must be approved before the resident starts. Both limit practice to the training program, so moonlighting requires a full license, and both end when the resident leaves the program. IMGs on the license route submit an ECFMG certificate. The exemption fee comes from board rule 0880-02-.02.", "source": "https://www.tn.gov/content/dam/tn/health/healthprofboards/medicalexaminers/Special-Training-Checklist-and-Forms.pdf" }, "fullLicenseFrom": "MD: after 1 year of ACGME training for US/Canadian graduates; 3 years (or ABMS board certification) for IMGs. DO: after a 1-year internship or PGY-1.", "incomeTax": { "type": "none", "rate2026": null, "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "Osteopathic residents fall under the Tennessee Board of Osteopathic Examination, which uses the same two routes; its Special Training License fee is $50 plus the state regulatory fee, and its exemption fee is $50 per resident per year." }, { "code": "TX", "name": "Texas", "board": { "name": "Texas Medical Board", "url": "https://www.tmb.texas.gov/" }, "trainingLicense": { "required": "yes", "name": "Physician-in-Training (PIT) permit", "whoApplies": "Resident, online, after the GME office or program coordinator supplies a TMB ID number; the program must certify the applicant before the permit is issued.", "leadTime": "Board rule 22 TAC 161.55: apply at least 60 and no more than 120 days before the program starts. The board suggests allowing 90 to 120 days for processing.", "fee": "$200 for the length of the residency; a $7 surcharge may be added", "renewal": "None; valid for the length of the training program", "notes": "Texas law requires residents to register with the board, and residents without a full Texas license hold a PIT permit. The permit covers supervised practice within the program only: outside moonlighting is not allowed, though moonlighting within the program's scope is. Changing programs requires a new application. Out-of-state residents rotating in Texas also need a permit.", "source": "https://www.tmb.texas.gov/apply-renew/physician/physician-apply/physician-in-training-permit-application" }, "fullLicenseFrom": "After 1 year of ACGME or AOA training for US/Canadian graduates (MD or DO); 2 years for IMGs, with additional IMG conditions.", "incomeTax": { "type": "none", "rate2026": null, "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": null }, { "code": "UT", "name": "Utah", "board": { "name": "Utah Division of Professional Licensing (DOPL)", "url": "https://commerce.utah.gov/dopl/physician-and-surgeon/" }, "trainingLicense": { "required": "no", "name": null, "whoApplies": null, "leadTime": null, "fee": null, "renewal": null, "notes": "Utah issues no resident training license. State law exempts people in a residency or fellowship program approved by DOPL while they are supervised (Utah Code 58-1-307(1)(c)). An exempt resident needs a Utah Controlled Substance License to prescribe controlled substances outside a hospital (Utah Admin. Code R156-67-305). The exemption does not cover moonlighting. DOPL's website does not describe resident licensure, so the statute is the source.", "source": "https://le.utah.gov/xcode/Title58/Chapter1/C58-1-S307_2025050720250507.html" }, "fullLicenseFrom": "After 24 months of ACGME (or, for DOs, AOA) training; or after 12 months for residents in PGY-2 or PGY-3 of a Utah program who agree to surrender the license if they leave the program.", "incomeTax": { "type": "flat", "rate2026": "4.45%", "localTaxNote": null, "source": "https://le.utah.gov/Session/2026/bills/enrolled/SB0060.pdf" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "MDs and DOs have shared one Medical Licensing Board since October 2024, and the same exemption covers DO residents. SB 60 (2026) cut the rate from 4.5% to 4.45% retroactive to January 1, 2026; the Tax Foundation's February 2026 table and the Tax Commission's rate page still show 4.5%." }, { "code": "VT", "name": "Vermont", "board": { "name": "Vermont Board of Medical Practice", "url": "https://www.healthvermont.gov/systems/board-medical-practice" }, "trainingLicense": { "required": "yes", "name": "Limited Temporary License (LTL), also called a training license", "whoApplies": "Resident, online; the program director or supervising physician signs a statement accepting responsibility.", "leadTime": null, "fee": "$75; renewal $75", "renewal": "Annual; licenses run July 1 to June 30", "notes": "Residents without a full Vermont license hold an LTL. It covers practice only within the approved program and its sites, so outside moonlighting is not covered. Residents from other states on away rotations in Vermont also need one. State law lets the board issue it up to 90 days before the training year; the board publishes no recommended lead time.", "source": "https://www.healthvermont.gov/systems/board-medical-practice/applications-licensing-and-fees" }, "fullLicenseFrom": "MD: after 2 years of ACGME training for US/Canadian graduates; 3 years (or specialty board certification) for IMGs. DO: after 1 year.", "incomeTax": { "type": "progressive", "rate2026": "top rate 8.75% (above $249,700 in 2025; threshold indexed annually)", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "DO residents get a separate limited temporary license from the Board of Osteopathic Physicians and Surgeons (Office of Professional Regulation): $75 to apply and $145 to renew each year, and it can be renewed or reissued only four times." }, { "code": "VA", "name": "Virginia", "board": { "name": "Virginia Board of Medicine", "url": "https://www.dhp.virginia.gov/Boards/Medicine/" }, "trainingLicense": { "required": "yes", "name": "Intern/resident/fellow training license (board rules call it a temporary or limited license)", "whoApplies": "Resident, online. The program certifies training dates on Form A and the medical school sends Form B.", "leadTime": "The board says to apply as soon as the appointment is confirmed and not to begin training before approval; it publishes no number of days.", "fee": "$55; renewal $35", "renewal": "Annual, on the recommendation of the program's GME director", "notes": "Virginia law bars GME programs from employing unlicensed interns or residents, so each resident needs this license or a full license before starting. The license is valid only within the training program's hospitals and clinics, and board rules bar outside employment that requires a full license.", "source": "https://www.dhp.virginia.gov/Boards/Medicine/AbouttheBoard/RegulatedProfessions/InternsandResidents" }, "fullLicenseFrom": "After 12 months of training in one accredited program (MD or DO); IMGs also need ECFMG certification.", "incomeTax": { "type": "progressive", "rate2026": "top rate 5.75% above $17,000", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "One board licenses MDs and DOs." }, { "code": "WA", "name": "Washington", "board": { "name": "Washington Medical Commission", "url": "https://wmc.wa.gov/" }, "trainingLicense": { "required": "varies", "name": "Physician and Surgeon Residency License (a limited license; the fee table lists it as Postgraduate Limited License)", "whoApplies": "Resident, online; the program director signs the appointment form recommending the resident.", "leadTime": "No apply-by date published; the commission's FAQ gives an average processing time of about four weeks.", "fee": "$411; renewal $411 (each includes $86 in state surcharges)", "renewal": "Annual, matched to the program year", "notes": "State law exempts residents in Washington training programs from licensure and says the commission may issue a residency license. The commission tells incoming residents to apply unless their program director says otherwise, so whether a resident must hold one depends on the program; many programs require it before training starts. The license covers residency duties only and does not allow moonlighting.", "source": "https://wmc.wa.gov/licensing/applications-and-forms/physician-limited-application" }, "fullLicenseFrom": "MD: after 2 years of ACGME training, for US/Canadian graduates and IMGs. DO: after 1 year.", "incomeTax": { "type": "none", "rate2026": null, "localTaxNote": null, "source": "https://dor.wa.gov/forms-publications/publications-subject/special-notices/new-tiered-rates-washingtons-capital-gains-tax" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "DO residents apply through the Department of Health to the Board of Osteopathic Medicine and Surgery, which issues a postgraduate limited license ($371 application, $351 annual renewal); state law also exempts DO trainees in board-approved programs. Washington does not tax wages. It taxes long-term capital gains at 7%, and 9.9% on gains above $1 million. A separate 9.9% income tax aimed at incomes above $1 million (ESSB 6346, 2026) is set to start with 2028 income." }, { "code": "WV", "name": "West Virginia", "board": { "name": "West Virginia Board of Medicine", "url": "https://wvbom.wv.gov/" }, "trainingLicense": { "required": "yes", "name": "Educational Permit", "whoApplies": "Resident completes Section A of a paper application; the program director or a board-authorized designee completes Section B and mails the original to the board.", "leadTime": "Board recommends applying at least three weeks before the training start date; training cannot begin while the application is pending.", "fee": "$100", "renewal": "Annual; permits expire June 30", "notes": "State law bars taking part in graduate medical training without a West Virginia license or educational permit, and this applies to residents who hold a full license elsewhere. The permit is limited to the training program, is not transferable between programs, and does not allow moonlighting. Before prescribing controlled substances, holders complete 3 hours of board-approved CME on prescribing and drug diversion. Values are from the board's 2026 application cycle.", "source": "https://wvbom.wv.gov/2026EDPERMITFAQ.asp" }, "fullLicenseFrom": "MD: after 1 year of approved GME for US/Canadian graduates; IMGs after 2 years, or 1 year plus ABMS board certification. DO: after 1 year.", "incomeTax": { "type": "progressive", "rate2026": "top rate 4.58% above $60,000", "localTaxNote": "Some cities charge a weekly city service fee, withheld from the pay of everyone who works there: Huntington $5 a week and Wheeling $2 a week. Charleston also charges one.", "source": "https://tax.wv.gov/Individuals/Pages/PersonalIncomeTaxReductionBill.aspx" }, "lastVerified": "2026-10-21", "confidence": "high", "notes": "DO residents get an educational permit from the separate West Virginia Board of Osteopathic Medicine: online application, $100 plus a 2.25% processing fee, expiring June 30 each year. SB 392 (signed March 31, 2026) cut each rate by about 5% retroactive to January 1, 2026; the Tax Foundation's February 2026 table shows the earlier 4.82% top rate." }, { "code": "WI", "name": "Wisconsin", "board": { "name": "Wisconsin Medical Examining Board (Department of Safety and Professional Services)", "url": "https://dsps.wi.gov/a-z-boards-and-councils-list/meb/" }, "trainingLicense": { "required": "yes", "name": "Resident Educational License (REL)", "whoApplies": "Resident, online; the medical school and the Wisconsin training program send their forms directly to DSPS.", "leadTime": "No apply-by date; DSPS says it reviews materials within about 10 days and asks applicants to plan ahead.", "fee": null, "renewal": "Annual, while enrolled in the program", "notes": "DSPS says the REL is required for the entire duration of training or until a full license is granted. The statute and board rule word it as optional, but the board's current page treats it as required. Practice is confined to the training program, so moonlighting is not covered. DSPS does not publish the REL fee.", "source": "https://dsps.wi.gov/a-z-professions-list/physician-mddo/resident-educational-licensure/" }, "fullLicenseFrom": "After 24 months of ACGME or AOA training, or after 12 consecutive months in the current program with the program director's endorsement that the resident will complete at least 24 months. The same applies to IMGs (plus ECFMG certification) and DOs.", "incomeTax": { "type": "progressive", "rate2026": "top rate 7.65% above $332,720", "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "One board licenses MDs and DOs." }, { "code": "WY", "name": "Wyoming", "board": { "name": "Wyoming Board of Medicine", "url": "https://wyomedboard.wyo.gov/" }, "trainingLicense": { "required": "varies", "name": "Training license: first-year (T-1) and second-year (T-2)", "whoApplies": "Resident, on a paper application by mail, with the signed residency contract and a recommendation form signed by the program director.", "leadTime": null, "fee": "T-1 $25; T-2 $50; T-2 renewal $50", "renewal": "Both expire June 30. A T-1 cannot be renewed; a T-2 can be renewed once.", "notes": "Wyoming law exempts supervised residents from the Medical Practice Act, and the board describes training licenses as available to residents in Wyoming programs, not required; whether one is needed depends on the program. T-1 holders may not moonlight and need a Wyoming-licensed physician's co-signature to prescribe legend drugs outside inpatient orders. T-2 holders (after one year of ACGME training) may prescribe independently and may moonlight after passing Step 3, with program director approval and notice to the board. The license ends if the holder leaves the program.", "source": "https://wyomedboard.wyo.gov/physicians/other-applications" }, "fullLicenseFrom": "Board rule: after 2 years of accredited training, or 1 year plus ABMS/AOA board certification or 5 years of full licensure elsewhere. The statute sets a 1-year minimum, but the board applies its rule.", "incomeTax": { "type": "none", "rate2026": null, "localTaxNote": null, "source": "https://taxfoundation.org/data/all/state/state-income-tax-rates-2026/" }, "lastVerified": "2026-10-21", "confidence": "medium", "notes": "One board licenses MDs and DOs." } ] }